Effects of wearing a FFP2 mask on indirect calorimetry measurements: A pilot study

Abstract

Background & aims During the coronavirus disease 2019 (COVID-19) pandemic the use of Indirect calorimetry (IC) during nutritional rehabilitation program requires special precautions due to possible contagions for patients and health professionals. We evaluated in a sample of healthy subjects the agreement between oxygen consumption (VO 2 mL/min), carbon dioxide production (VCO 2 mL/min), respiratory quotient (RQ) and resting energy expenditure (REE kcal/24 h/day) measured by IC with and without a filtering facepiece mask. Materials 10 subjects with a mean (SD) age of 43 (10) years and a body mass index of 25.2 (5.8) kg/m 2 underwent indirect calorimetry both with and without a class 2 filtering facepiece mask (FFP2), in random order. The limits of agreement (LOA) and the concordance correlation coefficient (CCC) were used to evaluate the interchangeability of the measurement conditions. Results The LOA between REE measured with and without FFP2 (−111 to 189 kcal/day) were comparable to those for repeated IC tests without wearing masks and CCC (0.95) showed substantial agreement. Conclusions We observed high agreement between REE measured by IC with and without FFP2 mask. These procedures are interchangeable in clinical practice.

The Impact of Ubiquitous Face Masks and Filtering Face Piece Application During Rest, Work and Exercise on Gas Exchange, Pulmonary Function and Physical Performance: A Systematic Review with Meta-analysis

“…Regarding the experimental setup, four designs studied the impact of mask wearing during rest [ 11 , 12 , 19 , 20 ], whilst twelve studies applied physical activity at low ( n = 3) [ 6 , 11 , 12 ], moderate ( n = 4) [ 6 , 21 – 23 ] or vigorous intensities ( n = 6) [ 8 , 24 – 28 ].…”

“…Breathing frequency was assessed in seven trials [ 6 , 8 , 12 , 22 , 24 , 25 , 27 ] and ventilation in five [ 6 , 8 , 24 – 27 ]. Breathing gas analysis of oxygen uptake was assessed in five studies [ 8 , 19 , 25 – 27 ] and carbon dioxide exhalation was analysed by three studies (VCO 2 ) [ 19 , 25 , 27 ]. Carbon dioxide partial pressure was measured via transcutaneous potentiometry (TcpCO 2 ) by three studies [ 6 , 12 , 22 ].…”

Clinical evaluation of the new indirect calorimeter in canopy and face mask mode for energy expenditure measurement in spontaneously breathing patients

“…Therefore, the use of Q-NRG® in face mask mode for REE measurement may not provide reliable results in the clinical setting. In addition, the use of face mask is problematic, especially under pandemic conditions, due to the lack of filtration system, unlike the canopy hood which can be utilized in patients wearing an FFP2 mask [29].…”

COVID-19: Lessons on malnutrition, nutritional care and public health from the ESPEN-WHO Europe call for papers

“…Also relevant for ICU patients, marked and prolonged hyper-metabolism was consistently described by different authors through indirect calorimetry [73e76]; from a methodological standpoint, poor predictive value of common equations to estimate energy expenditure was reported by one group [75]. A pilot study also addressed the issue of use of protective masks while implementing indirect calorimetry [77] suggesting superimposable results with or without protective device. In full agreement with the above observations, increased prevalence of malnutrition according to GLIM criteria was documented during hospital stay from 18 to 79% in one study, with 55% characterized as severe [68], and up to 80% malnutrition prevalence was reported at discharge from ICU also in another study [67].…”